Heat Stroke Summary
Research Summary
Hunter Jones
MICT III Clinical
Johnson County Community College
Research Summary
Heat stroke is defined by Knochel and Ouchama (2002, p. 1978) as “a core body temperature that rises above 40°C (105°F) and that is accompanied by hot, dry skin and central nervous system abnormalities such as delirium, convulsions, or coma.” Heat stroke can be the result of either exposure to a high environmental temperature or from an elevated core temperature due to strenuous exercise. However, due to the presentation of an ‘unconscious unknown’ the diagnosis of heat stroke can be a difficult one. Sudden loss of consciousness is a common presenting complaint in emergency departments. The complaint is evidence of a wide …show more content…
Knochel et al (2002, p. 1986) states, “effective heat dissipation depends on the rapid transfer of heat from the core to the skin and from the skin to the external environment. In persons with hyperthermia, transfer of heat from the core to the skin is facilitated by active cutaneous vasodilatation. Therapeutic cooling techniques are therefore aimed at accelerating the transfer of heat from the skin to the environment without compromising the flow of blood to the skin. This is accomplished by increasing the temperature gradient between the skin and the environment.” It is common practice today to use cold water or ice on the skin. However, these methods lower the skin temperature to a point that may trigger vasoconstriction and shivering. Knochel et al (2002, p. 1986) say that “to overcome this response, the patient may be vigorously massaged, sprayed with tepid water (40°C), or exposed to hot moving air (45°C), either at the same time as cooling methods are applied or in an alternating fashion.” There are currently no pharmacologic agents that are able to accelerate cooling in the treatment of heat stroke. However, dantrolene sodium has been considered. The goal of treatment should be the recovery of central nervous system function. A review study conducted by Vicario, Okabajue, and Haltom (1986, p. 395) record “the case of 39 patients with classic (non-exertional) heat stroke presenting to an urban emergency department were reviewed. Eight of 39 patients died. Rapid cooling, defined as a rectal temperature of ≤38.9°C (102°F) within an hour of presentation, was achieved in 27 of 39 patients. Twelve patients had a temperature ≥38.9°C (102°F) after one hour of treatment in the emergency department. The rate of mortality in the rapid cooling group was four of 27 (15%), while in the delayed cooling group, the mortality rate was four of 12 (33%) (P = 0.18).” This review study
Hunter Jones
MICT III Clinical
Johnson County Community College
Research Summary
Heat stroke is defined by Knochel and Ouchama (2002, p. 1978) as “a core body temperature that rises above 40°C (105°F) and that is accompanied by hot, dry skin and central nervous system abnormalities such as delirium, convulsions, or coma.” Heat stroke can be the result of either exposure to a high environmental temperature or from an elevated core temperature due to strenuous exercise. However, due to the presentation of an ‘unconscious unknown’ the diagnosis of heat stroke can be a difficult one. Sudden loss of consciousness is a common presenting complaint in emergency departments. The complaint is evidence of a wide …show more content…
Knochel et al (2002, p. 1986) states, “effective heat dissipation depends on the rapid transfer of heat from the core to the skin and from the skin to the external environment. In persons with hyperthermia, transfer of heat from the core to the skin is facilitated by active cutaneous vasodilatation. Therapeutic cooling techniques are therefore aimed at accelerating the transfer of heat from the skin to the environment without compromising the flow of blood to the skin. This is accomplished by increasing the temperature gradient between the skin and the environment.” It is common practice today to use cold water or ice on the skin. However, these methods lower the skin temperature to a point that may trigger vasoconstriction and shivering. Knochel et al (2002, p. 1986) say that “to overcome this response, the patient may be vigorously massaged, sprayed with tepid water (40°C), or exposed to hot moving air (45°C), either at the same time as cooling methods are applied or in an alternating fashion.” There are currently no pharmacologic agents that are able to accelerate cooling in the treatment of heat stroke. However, dantrolene sodium has been considered. The goal of treatment should be the recovery of central nervous system function. A review study conducted by Vicario, Okabajue, and Haltom (1986, p. 395) record “the case of 39 patients with classic (non-exertional) heat stroke presenting to an urban emergency department were reviewed. Eight of 39 patients died. Rapid cooling, defined as a rectal temperature of ≤38.9°C (102°F) within an hour of presentation, was achieved in 27 of 39 patients. Twelve patients had a temperature ≥38.9°C (102°F) after one hour of treatment in the emergency department. The rate of mortality in the rapid cooling group was four of 27 (15%), while in the delayed cooling group, the mortality rate was four of 12 (33%) (P = 0.18).” This review study